Sir: We read with great interest the three cases reported by McDougle et al., in which patients with OCD refractory to fluvoxamine were treated with risperidone. We have also had a positive experience combining risperidone with an SSRI in a patient with compulsive tattooing (case report pending review). We assume the authors were not able to acknowledge the small open add-on trial of risperidone reported by Jacobsen due to the lag time between submission and publication.